Exhibit_12-B_Bidder’s_List_of_Subcontractors_(DBE_and_Non-DBE).pdf

Amount

Subcontracted

DIR Reg Number

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Local Assistance Procedures Manual Exhibit 12-B Bidder’s List of Subcontractors (DBE and Non-DBE)

Exhibit 12-B: Bidder’s List of Subcontractor (DBE and Non-DBE) - Part 1

As of March 1, 2015 Contractors (and sub-contractors) wishing to bid on public works contracts must be registered with the State Division of Industrial Relations and certified to bid on Public Works contracts. Please register at https://www.dir.ca.gov/Public-Works/Contractor- Registration.html. The local agency will verify registration of all contractors and subcontractors on public works projects at bid and thereafter annually to assure that yearly registration is maintained throughout the life of the project.

In accordance with Title 49, Section 26.11 of the Code of Federal Regulations, and Section 4104 of the Public Contract Code of the State of California, as amended, the following information is required for each sub-contractor who will perform work amounting to more than one half of one percent (0.5%) of the Total Base Bid or $10,000 (whichever is greater).

FEDERAL PROJECT NUMBER:

Photocopy this form for additional firms.

Subcontractor Name & Location Line Item & Description Subcontract Percentage of Bid Item

Contractor License Number DBE (Y/N) DBE Cert Number Annual Gross Receipts

NAME < $1 million < $5 million < $10 million

City, State < $15 million ge of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million ge of Firm in years NAME < $1 million

< $5 million < $10 million

City, State < $15 million ge of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million ge of Firm in years NAME < $1 million

< $5 million < $10 million

City, State < $15 million ge of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million ge of Firm in years NAME < $1 million

< $5 million < $10 million

City, State < $15 million ge of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million ge of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million Age of Firm in years

Distribution – Original: Local Agency File; Copy: DLAE w/Award Package

September 2021 https://www.dir.ca.gov/Public-Works/Contractor-Registration.html https://www.dir.ca.gov/Public-Works/Contractor-Registration.html

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Local Assistance Procedures Manual Exhibit 12-B Bidder’s List of Subcontractors (DBE and Non-DBE)

Exhibit 12-B: Bidder’s List of Subcontractor (DBE and Non-DBE) - Part 2

In accordance with Title 49, Section 26 of the Code of Federal Regulations, the Bidder shall list all subcontractors who provided a quote or bid but were not selected to participate as a subcontractor on this project.

FEDERAL PROJECT NUMBER:

Photocopy this form for additional firms.

Subcontractor Name & Location Line Item & Description Subcontract Amount

Percentage of Bid Item

Subcontracted

Contractor License Number DBE (Y/N) DBE Cert Number Annual Gross Receipts

DIR Reg Number

NAME < $1 million < $5 million < $10 million

City, State < $15 million e of Firm in years NAME < $1 million

< $5 million < $10 million

City, State < $15 million e of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million e of Firm in years NAME < $1 million

< $5 million < $10 million

City, State < $15 million e of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million e of Firm in years NAME < $1 million

< $5 million < $10 million

City, State < $15 million e of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million e of Firm in years NAME < $1 million

< $5 million < $10 million

City, State < $15 million e of Firm in years

NAME < $1 million < $5 million < $10 million

City, State < $15 million

Age of Firm in years

Distribution – Original: Local Agency File; Copy: DLAE w/Award Package

September 2021